Menopause is a natural transition period in a woman’s life, and it occurs on average at age 51. During menopause, a woman’s body produces less estrogen and progesterone, and her ovaries stop producing eggs. Menstruation becomes less frequent and eventually stops altogether.

Managing Life’s Changes

By Jenni Frankenberg Veal

Menopause has three stages:

Perimenopause: Perimenopause typically begins several years before menopause when the ovaries begin to produce less estrogen. In the last one to two years of perimenopause, the decrease in estrogen accelerates. At this stage, many women experience symptoms of menopause.

• Menopause: Menopause is confirmed when a woman has not had a menstrual period for 12 consecutive months. At this stage, her ovaries have stopped releasing eggs and producing most of their estrogen.

Postmenopause: These are the years after menopause when menopausal symptoms such as hot flashes become less frequent.

Symptoms of Menopause

In some women, menstrual flow comes to a sudden halt. However, it is more common for it to stop over time. During this time, a woman’s menstrual periods can also become closely or widely spaced. Irregularity may last for one to three years before menstruation finally ends completely.

Common symptoms of menopause include heart pounding or racing, hot flashes, night sweats, skin flushing and insomnia. Other symptoms of menopause may include decreased interest in sex, forgetfulness, headaches, mood swings including irritability, depression, anxiety, urine leakage, vaginal dryness and painful sexual intercourse, vaginal infections, joint aches and pains, and irregular heartbeat.

Blood and urine tests can be used to measure changes in hormone levels, signaling when a woman is close to menopause or has already gone through menopause. Examples of these tests include:

• Estradiol (E2) Test: An estradiol test measures the amount of a hormone called estradiol in the blood. Estradiol is the most important form of estrogen found in the body. Most of it is made in and released from the ovaries.

• FSH Test: A FSH blood test measures the amount of a hormone called FSH in the blood, a follicle-stimulating hormone released by the anterior pituitary gland. FSH stimulates production of eggs and estradiol during the first half of the menstrual cycle.

• LH Blood Test: The LH blood test measures the amount of luteinizing hormone (LH) in the blood, a hormone released by the pituitary gland. An increase in LH levels at mid-cycle causes ovulation.

Surviving Menopause

The transition to postmenopause is a normal part of the aging process. It is a time of physical change, and women can expect to have both positive and negative emotional responses to this change. Many women celebrate a sense of freedom from birth control concerns and menstrual bleeding. Often women find this time of life highly productive in their work and personal lives. However, it is also common to feel unsettled about body changes that seem beyond one’s control.

Women can take steps to help manage menopause. These include eating well, getting plenty of rest, avoiding excess caffeine, alcohol and sugars, and having a relaxed attitude about menopause. This will help to improve a woman’s emotional and physical well-being.

Tension and anxiety can make symptoms worse. Use relaxation techniques such as rhythmic breathing exercises, yoga, and biofeedback and regular exercise to manage stress. Find a support group to discuss common issues that come up before and after menopause. If depression, moodiness, or irritability interfere with daily life, discuss this with a health professional.